OBJECTIVES:

In the issue of hip joint endoprostheses, surgeons can choose different approaches. Two surgical approaches were selected for a comparison – the conventional (commonly used) and the minimally invasive, which is the most discussed novelty in current alloplasty. The aim of this study is to figure out cost effectiveness using cost-effectiveness analysis, comparison of operational approaches, and determination of a more cost-effective option.

METHODS:

Methods of value engineering and multiple-criteria decision making, especially Saaty’s matrix, the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) and the Analytic Hierarchy Process (AHP), were used for setting the scales of criteria and the effects, respectively. The total direct costs per patient had been calculated in the cost analysis made from the healthcare provider’s perspective. The cost-effectiveness analysis and the sensitivity analysis were carried out at the end of the study.

RESULTS:

A total of 180 patients have been enrolled to the study. The total costs per patient are CZK 57 084 (~EUR 2 173) for the conventional approach, and CZK 54 321 (~EUR 2 068) for the minimally invasive approach. The CEA indicator value with the TOPSIS method is 7.99*10^-6 for the conventional approach, and 11.29*10^-6 for the minimally invasive approach. These results were also confirmed using the AHP method, in which case the CEA indicator value with the AHP method is 8.86*10^-6 for the conventional approach, and 9.42*10^-6 for the minimally invasive approach.

CONCLUSIONS:

Minimally invasive approaches provide results at least comparable with those established former. This study concludes that they are not more expensive than the standard methods, while providing slightly better clinical results. The differences in both approaches are insignificant, but based on the results of the cost-effectiveness analysis, the minimally invasive approach is all-in-all more cost effective.